Family Insurance
Everything You Need to Know About Family Insurance at a Glance
- Under statutory health insurance, a spouse and children can be covered at no cost if the requirements are met.
- The requirement is that the co-insured person has only a small income and lives in Germany.
- Children can be covered under family insurance until at least age 18, or until age 25 if they are in school, vocational training, or college.
- Children with a disability remain covered under family insurance without an age limit if they are unable to care for themselves.
- If the eligibility requirements no longer apply, the person becomes an independent, premium-paying member of the health insurance plan.
- Starting in 2028, an additional premium will be due for some co-insured spouses and registered domestic partners under family coverage. Children remain premium-exempt.
Family Insurance: Covered at No Additional Cost
Under the statutory health insurance system, a spouse and children can be covered free of charge under certain conditions. This means they do not have to pay their own health insurance premiums. The insured member simply needs to register these family members with the health insurance provider. Read here to find out who is eligible for free coverage.
When does family insurance make sense?
Family insurance provides financial relief for many families. It is particularly beneficial
- when one parent works fewer hours or temporarily stops working altogether to care for the children,
- while receiving maternity and parental benefits,
- during the children’s school years and college,
- and for those with low incomes.
Family insurance is not available under private health insurance plans. In those plans, all family members must pay their own premiums.
What requirements must be met for family insurance?
Non-contributory family insurance is available if
- the family member to be insured has his or her domicile or habitual residence in Germany,
- the family member covered by the policy has only a small amount of personal income that does not exceed the statutory income limit (parental allowance is not taken into account),
- there is no other health insurance that precludes family insurance, such as mandatory insurance as an employee or retiree,
- and the person is not primarily self-employed.
Family Health Insurance Starting in 2028: What Will Change for Families?
Starting January 1, 2028, new rules will apply to statutory family health insurance. The Contribution Stabilization Act is intended to ensure high-quality care for the coming years and limit rising contribution rates as much as possible.
Some co-insured spouses and registered partners will then be required to pay an additional contribution. A 2.5% surcharge will be calculated based on the primary earner’s income for the spouse or partner. Children remain exempt from premiums. Those who care for children under 12, care for a relative, or meet certain requirements will also continue to be covered without having to pay premiums.
In our FAQ at the bottom of the page, we answer common questions about the upcoming changes.
Who is eligible for family coverage?
If the requirements are met, the following individuals may be covered under the policy at no additional cost:
- Spouses
- Registered civil partners under the Civil Partnership Act
- Children up to age 18
- Children up to age 23, provided they are not employed, e.g., because they are attending school
- Children up to age 25 while pursuing vocational training or a degree. An extension for an additional 12 months is possible if the training was interrupted by military service, voluntary service, or work as a development aid worker.
- Children with a disability, if they are unable to care for themselves. They can remain covered under family insurance indefinitely—with no age limit.
- Stepchildren and grandchildren, if the member is their primary provider.
- Foster children living in the same household.
- A separated spouse until the divorce decree becomes final.
Who is not eligible for family insurance?
Certain occupational groups are excluded. These include civil servants, judges, military personnel, and members of the clergy.
If one parent has private health insurance and the other has public health insurance, family coverage is not available if
- the parent with private insurance earns more than the parent with public insurance and
- the privately insured parent’s total monthly income regularly exceeds one-twelfth of the annual income limit (JAEG). You can find out the current income limit from your health insurance provider.
In this case, children must either be insured under private health insurance as well or become voluntary members of the statutory health insurance system.
How can I switch from individual insurance to family insurance?
Anyone who had private health insurance and meets the requirements for family coverage can switch. The insured person must retroactively cancel their private health insurance within 3 months of the start of family coverage. Those covered under family insurance must submit a membership certificate from their new insurer to their former private health insurer within two months, stating the reason for the switch to statutory insurance.
What happens if the eligibility requirements for family insurance are no longer met?
If the requirements for family coverage are no longer met, the individuals concerned automatically remain covered under voluntary health insurance but must then pay their own premiums. However, the insured person may choose to withdraw from the plan if he or she wishes to switch health insurance providers or enroll in private health insurance.
Frequently Asked Questions from Parents About Family Insurance
Frequently Asked Questions About the Statutory Health Insurance Premium Stabilization Act
Where can we find help and advice?
If you have questions about family health insurance, it’s best to contact your statutory health insurance provider directly. There, you can get advice and also find out whether the new regulations taking effect in 2028 will affect your family in your specific situation.
For general questions about statutory health insurance, the Federal Ministry of Health offers a citizen hotline. For questions about health insurance, you can reach the citizen hotline Monday through Wednesday from 8 a.m. to 4 p.m., Thursday from 8 a.m. to 6 p.m., and Friday from 8 a.m. to noon.
The Patient Counseling Service in North Rhine-Westphalia provides free and independent advice on issues related to statutory health insurance and patient rights.
The NRW Consumer Advice Center provides advice on, among other things, statutory health insurance and the financial implications of the reform.